CN102421384A - 具有集成的照相机和照明器具的套管 - Google Patents

具有集成的照相机和照明器具的套管 Download PDF

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CN102421384A
CN102421384A CN2010800208599A CN201080020859A CN102421384A CN 102421384 A CN102421384 A CN 102421384A CN 2010800208599 A CN2010800208599 A CN 2010800208599A CN 201080020859 A CN201080020859 A CN 201080020859A CN 102421384 A CN102421384 A CN 102421384A
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CN102421384B (zh
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A·C·麦金利
M·B·普利诺维茨
P·E·麦金利
J·R·普劳菲
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New View Surgical Inc
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    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/34—Trocars; Puncturing needles
    • A61B17/3494—Trocars; Puncturing needles with safety means for protection against accidental cutting or pricking, e.g. limiting insertion depth, pressure sensors
    • A61B17/3496—Protecting sleeves or inner probes; Retractable tips
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B1/00—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor
    • A61B1/00064—Constructional details of the endoscope body
    • A61B1/00071—Insertion part of the endoscope body
    • A61B1/0008—Insertion part of the endoscope body characterised by distal tip features
    • A61B1/00087—Tools
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B1/00—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor
    • A61B1/04—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor combined with photographic or television appliances
    • A61B1/05—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor combined with photographic or television appliances characterised by the image sensor, e.g. camera, being in the distal end portion
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B1/00—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor
    • A61B1/06—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor with illuminating arrangements
    • A61B1/07—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor with illuminating arrangements using light-conductive means, e.g. optical fibres
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/34—Trocars; Puncturing needles
    • A61B17/3417—Details of tips or shafts, e.g. grooves, expandable, bendable; Multiple coaxial sliding cannulas, e.g. for dilating
    • A61B17/3421—Cannulas
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B90/00—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
    • A61B90/30—Devices for illuminating a surgical field, the devices having an interrelation with other surgical devices or with a surgical procedure
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/34—Trocars; Puncturing needles
    • A61B17/3417—Details of tips or shafts, e.g. grooves, expandable, bendable; Multiple coaxial sliding cannulas, e.g. for dilating
    • A61B17/3421—Cannulas
    • A61B2017/3445—Cannulas used as instrument channel for multiple instruments
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/34—Trocars; Puncturing needles
    • A61B17/3417—Details of tips or shafts, e.g. grooves, expandable, bendable; Multiple coaxial sliding cannulas, e.g. for dilating
    • A61B2017/3454—Details of tips
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/34—Trocars; Puncturing needles
    • A61B17/3417—Details of tips or shafts, e.g. grooves, expandable, bendable; Multiple coaxial sliding cannulas, e.g. for dilating
    • A61B2017/3454—Details of tips
    • A61B2017/346—Details of tips with wings
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B90/00—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
    • A61B90/36—Image-producing devices or illumination devices not otherwise provided for
    • A61B90/361—Image-producing devices, e.g. surgical cameras

Abstract

一种套管组件，包括形成内腔的管状元件、所述管状元件的可展开部以及安装于所述管状元件的可展开部上的电子构件。所述管状元件具有近端和适于插入到体腔内的远端。所述管状元件的可展开部接合在所述管状元件的远端附近，以在闭合位置和打开位置之间转换。当所述可展开部处于闭合位置时，所述电子构件至少部分位于所述内腔内。

Description

具有集成的照相机和照明器具的套管
相关申请的交叉援引
本申请主张共同未决的于2009年3月27日提交的题为“具有嵌入式照相机和照明器具的套管”的美国临时专利申请序列号61/164,215和于2009年11月17日提交的题为“形状记忆合金组，包括形状记忆合金夹子、封闭件、以及内窥镜转向的应用”的美国临时专利申请序列号61/261,910的优先权，二者的公开内容在此通过援引整体合并本文。
技术领域
本发明总体涉及具有集成的成像和照明设备的套管，更具体地涉构造有可展开部的那些套管。
背景技术
在微创外科手术中，常存在身体中做出的若干小切口，以插入外科工具、注入设备、内窥镜、或其它观察设备。外科医生现正以使切口数量最少的方式(可能仅有一个，称为单孔切口或单孔进出通路(SPA))进行手术。外科医生还采用天然孔口(诸如口腔)，从而为不采用切口或仅采用体内切口的手术提供进出通路。
外科医生通过尽可能减少切口部位数量所追求的优点在于，减少患者创伤、减少感染发生、改善恢复时间、并减少整形损伤。
切口位置的减少将改变外科医生及其团队工作的方式。有可能在进出部位周围不再有容纳通常将保持并调整在外科手术区域周围的器械的多个外科医生的空间。单个外科医生可能需通过一个进出部位来控制所有用于手术的器械。
例如，通过管状套管进行的内窥镜外科手术已发展多年。当前，外科医生是在躯干体区域的任何中空内脏被注入之后中在该中空内脏中进行手术。典型地，多个窄套管通过皮肤中的各个小进入伤口(即孔)各自插入，以容纳各种器械以及改变观察角度。为了完成它们的插入，单独的套针与套管一起使用，以穿刺体腔。套针是放置在套管内的导引件，依赖于它是用于穿刺皮肤还是经由单独做出的切口进入，导引件带有尖切削刃或钝头。一旦插入套管，便移除套针，以使中空套管就位，以供手术过程中使用。
成像和/或照明构件的进入和展开可辅助外科手术，诸如内窥镜手术。具有可展开成像和/或照明构件的管状套管的实例在Irion的美国专利5,166,787、Saadat等人的美国专利申请公开号2009/0275799、Thompson的美国专利申请公开号2009/0259097、以及Cooper等人的美国专利申请公开号2008/0065099中有描述，所有这些专利的公开内容在此通过援引而整体合并入本文。
由此，在本领域中需要这样一种外科装置组件，所述组件使套针套管与成像和照明能力相结合，以使得每次手术在身体中的开口数量最少。
发明内容
现有技术的外科器械缺乏在插入过程中保护成像器件和照明器件二者的光学器件的能力，且缺乏获得偏离套管轴线的观察角度的能力。本发明的一个目的在于，当采用比通常所需的切口少的切口时，在微创外科手术中更容易控制进出、成像以及器械的使用。通过将套管、成像和照明相组合，单个设备可替代若干设备，由此允许更有效且更容易控制的进出。
在本发明的一个实施例中，外科装置包括套针、套管、以及成像和照明构件的组合。在该实施例中，这种组合给外科医生提供改进的外科手术腔的观察。替代实施例允许患者上的切口数量减少。
所述装置还允许开发改进的外科手术方法，所述改进的外科手术方法包括减少切口数量，改善外科手术腔的成像、和/或改善执行外科手术的有效性。
在一个方面，本发明涉及一种套管组件，具有：管状元件，其形成内腔，所述管状元件具有近端和适于插入到体腔内的远端。所述套管组件包括所述管状元件的可展开部，其接合在所述管状元件的远端附近，以在闭合位置和打开位置之间转换。所述套管组件包括电子构件，其安装于所述管状元件的可展开部上，从而，当所述可展开部处于闭合位置时，所述电子构件至少部分位于所述内腔内。
在前述方面的一个实施例中，所述打开位置包括多个位置。在另一个实施例中，所述电子构件布置成当所述可展开部处于打开位置时远离所述内腔。在又一个实施例中，所述可展开部包括所述管状元件的壁部分。在另一个实施例中，所述套管组件还包括可移除套针，所述可移除套针适于在所述可展开部处于闭合位置时安装到所述内腔中。在一个实施例中，在所述可展开部处于闭合位置时，所述可展开部在所述管状元件的远端处形成尖头。在另一个实施例中，所述尖头包括光学透明材料，以在所述可展开部处于闭合位置时通过所述尖头将图像投射到所述电子构件上。
在上述方面的另一个实施例中，所述电子构件可以是图像传输构件、照明构件及它们的组合。在另一个实施例中，所述图像传输构件可以是电荷耦合器件照相机、互补金属氧化物半导体成像器件、以及光纤线缆。在一个实施例中，所述照明构件可以是光源和光纤线缆。在另一个实施例中，所述光源可以是发光二极管、有机发光二极管、白炽灯、电致发光源、以及激光源。
在上述方面的另一个实施例中，所述管状元件的可展开部经由铰链装置在打开位置和闭合位置之间转换。在一个实施例中，所述铰链装置设置于所述管状元件中。在另一个实施例中，所述铰链装置包括枢轴。在又一个实施例中，所述铰链装置设置于所述管状元件的圆周上。在另一个实施例中，所述铰链装置包括周向铰链。在一个实施例中，所述铰链装置设置于所述管状元件的外部。在另一个实施例中，所述铰链装置包括至少一个四连杆机构。
在前述方面的另一实施例中，所述套管组件还包括致动机构，所述致动机构构造成使所述可展开部在闭合位置和打开位置之间转换。在另一个实施例中，所述致动机构包括：设置于所述近端附近的旋钮；至少一个连接件，其与所述旋钮联接；以及铰链装置，其与所述至少一个连接件和所述可展开部连接，从而所述旋钮的旋转使所述可展开部在闭合位置和打开位置之间转换。
在另一方面中，本发明涉及一种使用套管组件的方法，包括：将具有内腔的管状元件插入到体腔中，其中，所述管状元件具有近端和远端；以及将所述管状元件的可展开部围绕所述远端自闭合位置向打开位置致动，其中，当所述可展开部处于闭合位置时，安装于所述可展开部上的电子构件至少部分位于所述内腔中，而当所述可展开部处于打开位置时，所述内腔基本没有障碍物。
在前述方面的一个实施例中，所述使用套管组件的方法还包括：采用所述电子构件来观察所述体腔的超出所述远端的部分。在一个实施例中，所述方法还包括：当所述可展开部处于打开位置时，使外科工具和第二电子构件中的至少一个穿过所述内腔且超出所述远端。在另一个实施例中，所述方法还包括：首先将一插入套管引入到体腔中，从而经由所述插入套管插入所述管状元件。在一个实施例中，所述方法还包括：经由所述插入套管将所述套管组件从体腔中抽出，使得通过所述插入套管施加到所述套管组件上的力将所述可展开部运动至闭合位置。
附图说明
当与附图一起阅读时，从下面各个实施例的说明中，能更完整地理解本发明的其它特征及优点以及本发明本身，在附图中：
图1示出根据本发明一实施例的处于闭合位置的套管组件的示意立体图；
图2示出图1的套管组件处于它的打开位置之一时的示意立体图；
图3示出图2的套管组件的头部的放大示意立体图；
图4示出根据本发明一实施例的套管组件的另一实施例的头部处于其打开位置之一的放大示意立体图；
图5A和图5B示出根据本发明一实施例的套管组件的头部的示意剖视图以及示意局部剖开立体图，其中成像构件构造成用于在套管组件处于闭合位置时向前观察。
图6示出根据本发明一实施例的套管组件的另一实施例的处于其打开位置之一的头部的示意立体放大图；
图7A和图7B示出根据本发明一实施例的致动机构的示意放大剖视图和示意立体图，所述致动机构连接于套管组件的处于打开和闭合位置的可展开部；
图8示出根据本发明另一实施例的套管组件的处于其打开位置之一的头部的示意立体放大图；以及
图9A、图9B和图9C示出根据本发明一实施例的所述装置的另一头部的实施例的示意立体图和示意剖视图，所述装置具有在闭合时向前观察的能力、且具有可移除套针。
具体实施方式
为了提供本发明的完全理解，现在将说明某些说明性实施例，包括用于显示图像的装置和方法。然而，本领域普通技术人员将理解的是，在此说明的系统和方法可进行改造并修改以针对所致力的应用场合变得合适，而且在此说明的系统和方法可应用于其它合适的应用场合。所有这些改造和修改将被视为处于本发明的范围内。
图1和图2分别示出处于闭合位置和打开位置的套管组件100的实施例的示意立体图。在一个实施例中，套管组件100包括形成内腔202的管状元件110。管状元件110的近端114可适于由外科医生或临床医生来操纵，而远端116可适于插入到体腔内。具有手柄104的壳体108可连接于近端114附近或连接在近端114处，以用于由外科医生或临床医生操纵。在替代实施例中，管状元件110可形成各种横截面形状，例如大体圆形或柱形、椭圆形、三角形、方形、矩形、以及D形(其中一侧边为平的)。
套管组件100的远端的全部或一部分能被定位到闭合位置102，以用于直接插入到体腔中和抽出，或者通过另一注入套管(insufflatingcannula)而插入和抽出。当闭合时，远端组件形成尖头，诸如能够穿刺患者皮肤的套针。在另一实施例中，管状元件110的内腔202能被装配有可收回和/或可移除套针，诸如在图9A-9C中所示并在下面进一步说明的那些。在一个实施例中，套针由实心的非透明材料制成；但是，在另一实施例中，套针的全部或部分由光学透明或透光材料制成。
管状元件110的远端116的一个或多个部分可设计成在插入到体腔中后打开。在一个实施例中，如图3所示，管状元件110的至少一个可展开部204基于打开调整装置106(即致动机构)操作而具有可调整的展开角度。例如，调整装置106可使可展开部204在闭合位置和打开位置之间运动。可替代地，调整装置106还可使可展开部204在闭合位置和任意数量的多个打开位置之间运动。在另外或替代实施例中，可展开部204容纳电子构件，当处于闭合位置时，电子构件至少部分地置于所述内腔中。在替代实施例中，所有电子构件容纳在管状元件的壁内。当可展开部204运动到至少一个打开位置时，由于电子构件从所述内腔中移出，所以腔202基本上无障碍物，从而在操作或外科手术过程中各种器械(例如外科工具或其它电子构件)可通过所述内腔并被使用。
所述电子构件包括与一个或多个照明构件305结合的一个或多个图像传输构件304。在一个实施例中，图像传输构件304可为电荷耦合器件(CCD)照相机，互补金属氧化物半导体(CMOS)成像器件和/或成像光纤缆线、以及它们的用于动力、通讯和其它功能的辅助光学和电子驱动器。
从光学的角度而言，图像传输构件304中的一个或多个还可横跨光谱(包括人眼不可见的那些部分，诸如红外线和紫外线)来成像。在一个实施例中，两个图像传输构件可构造成捕捉立体图像(静态的和/或动态的)。在一个实施例中，图像传输构件304中的一个或多个可构造成具有固定光学器件、自适应光学器件和/或有源光学器件的任意组合。自适应光学器件和主动光学器件能够聚焦到图像或目标区上和/或缩放图像或目标区。
在一个实施例中，一个或多个图像传输构件304能够捕捉运动图像和静止图像，并将它们经由容纳于或连接于壳体108、手柄104、内腔202和/或管状元件110壁的有线或无线通讯装置118传输给外科医生或操作员。这种通讯装置118可包括诸如模拟和/或数字的电信号、或光纤通讯系统。
照明构件305可以是一个或多个光源或照明源306、308及其辅助电子驱动器310。在一个实施例中，照明源306、308为发光二极管(LED)、有机发光二极管(OLED)、照明光纤、白炽灯、电致发光源和/或激光源。在一个实施例中，照明构件305被构造成以光学和频谱特性与图像传输构件304密切工作，同时优化照明面积、照明等级及均匀性。在一个实例中，这可以意味着照明等级受外科医生或临床医生控制，但是，在其它实例中，图像传输构件自动增益控制(AGC)与照明构件305的照明等级相关联。
在一个实施例中，如图7A和图7B所示，调整装置106可包括：旋钮701，其连接于旋转轮702；以及连接件704、706，其沿管状元件110的长度行进通过所述内腔。在替代实施例中，推杆可用于替代旋钮701。在另一替代实施例中，连接件704、706行进通过在管状元件110的壁中形成的一个或多个纵向孔。转动旋钮701将引起轮702沿一个方向旋转，这将在连接件706的一端上进行拉动，并将力传递至它的另一端(所述另一端连接于铰链714的下游部分712)并打开可展开部204。旋钮701的部分转动可例如使可展开部204运动到任意中间打开位置。旋钮701的相同但相反的转动将拉动连接件704(其连接于铰链714的上游部分710)并使可展开部204闭合。连接件704可为刚性或柔性元件，诸如杆、棒、缆、线等。可替代地，可采用螺母和导螺杆的组合。作为旋钮701的替代，可采用杠杆。类似地，作为旋钮701的替代，弹簧加载的释放机构可致动可展开部204。在替代实施例中，可利用磁性系统致动可展开部204。在这种构造中，可展开部204装配有磁体(例如永磁体或铁磁性对象)。位于身体或患者外部的互补磁体(例如永磁体或电磁体对象)用于与可展开部204上的磁体相互作用，从而通过使外部磁体围绕并相对可展开部204运动，操作员可打开和闭合可展开部204。
用于打开/闭合可展开部204的铰链装置可过许多方式来实现。在一个实施例中，可展开部204中的一个或多个经由铰链装置而在闭合位置和多个打开位置之间转换。所述铰链装置可包括如下的铰链：其置于管状元件110的壁内(例如全部或一部分位于内腔202内)、围绕枢轴部位设置、设置在管状元件110的圆周上(例如周向铰链)、和/或设置在管状元件110的外部上。可替代地，铰链装置可包括至少一个四连杆机构。
在替代实施例中，内腔202通过使连接件704、706经过沿管状元件110壁的凹部或在管状元件110壁内形成的缝隙来保持畅通无阻。在替代实施例中，调整装置106包括由外科医生或临床医生操作的、驱动一个或多个马达的机电致动开关。所述马达或致动器可定位在管状元件110的近端114(例如非可展开部)内，或者可定位在可展开部204内。可替代地，可展开部204可经由气动或液压致动器来运动。
在替代实施例中，将可展开部204连接于远端116的所述铰链可包括带有或不带有辅助加热元件的形状记忆合金(SMA)材料。在一个实施例中，利用诸如镍钛诺(Nitinol)之类的材料(定位在内腔202、管状元件110和/或可展开部204内)，任何可展开部204可在室温下(例如25℃)下闭合并在低于体腔内预期温度的温度(例如低于37℃)下展开。在替代实施例中，辅助加热元件可由外科医生或临床医生控制。辅助加热元件的电压可沿管状元件110壁传输。辅助加热元件用于在SMA材料处于体腔中后将SMA材料置于可展开温度范围中；例如增加电压将增加SMA材料的温度，这将使得可展开部204转换到它的打开位置中的一个或多个。取消或降低电压(且由此取消或降低热量)使得可展开部204转换到它的闭合位置。
在一个实施例中，如图6所示，连接件612为单个元件，例如为条带或杆，其由金属或其它非屈曲构造制成；当外科医生经由操作旋钮701而朝远端推送该连接件时，所述连接件朝内腔604的远端延伸。延伸压力迫使可展开部602上的铰链装置608、614翻转并旋转至一个或多个打开位置，这引起在此之前面向远端的部分610此时面向近端。在这种构造下，成像构件606和照明构件616面向感兴趣的区域。可展开部602的打开角度可经由旋钮701的旋转或其它结构调整机构、借助连接件612被送入到管状元件110中的量来进行调整。这种布置允许：当闭合时，成像构件606和照明构件616占据几乎或全部的内腔604；当打开时，使内腔604基本敞开并可用于器械插入/操作和/或取出器械和身体样本。另外，这种布置在闭合时保护任何成像或照明构件，同时允许通过调整可展开部602和/或成像构件606和照明构件616的打开角度来实现相同程度的三角测量(triangulation)。也可以使用类似的铰链装置以及调整装置来代替本文描述的那些。
在替代实施例中，如图8所示，铰链装置为带有臂802、803的四连杆机构(four-bar linkage)，臂802、803附接于可展开部804。在这种设置中，可展开部804可如上所述的那样来类似地致动。例如，在内部通过管状元件110壁的一个或多个连接件连接于臂802、803。旋钮的旋转或推杆的推送使可展开部804升到管状元件110上方。成像构件606和照明构件616容纳在可展开部804中。
在替代实施例中，如图4所示，管状元件110可包括多个可展开部，例如两个或三个可展开部。例如，如图4所示，一个实施例包括两个可展开部，一个可展开部205带有电子构件(例如一个或多个图像传输构件和/或一个或多个照明构件)，另一个可展开部314不带有电子构件。可替代地，可展开部205、314可均包括电子构件。可展开部205、314之一或二者可响应用户输入而打开。可展开部的数量仅仅受限于将管状元件110的圆周以相同或不同尺寸的部分分割的能力。采用在此讨论的调整装置的任何组合，可形成一个或多个这种可展开部。这就给予了外科医生或临床医生额外的自由度，避免在外科手术或操作进行的区域中发生套管干扰。
在一个实施例中，包含电子构件的可展开部204通过机械连接件来致动，而其它不带电子构件的可展开部314采用SMA装置进行展开。这将允许带有电子构件的可展开部204的良好的指向/三角测量，而对于其它可展开部314允许使用更简单、不那么精确的调整机构。在另外的实施例中，补充的电子器件组容纳在各可展开部204、314中，以提供由外科医生或操作员可选择的系统冗余。在另一实施例中，管状元件110可包括三个可展开部，一个包含图像传输构件，另一个包含照明构件，而最后一个不具有电子构件。可替代地，在每一个所述可展开部上可设置图像传输构件和照明构件中的至少一个或多个。
管状元件110的可展开部204构造成从与管状元件110对齐的闭合位置(即处于零度)移动到无限数量的打开位置(相对于由管状元件110限定的中心线轴线从零度到180度)。这提供给外科医生或操作员以有效地“三角测量/观察”图像传输构件和照明构件的视野中的一个或多个。如图4中可看到的，调整可展开部204相对管状元件110的轴线402的打开角度α使得例如图像传输构件或照明构件的观察方向404在不使套管运动的情况下得以调整。这允许视野稍微变化，而不需使套管运动。在手术中，使套管运动可相对于正被动手术的器官或身体结构影响器械的位置。在使用时，套管可被旋转，以使得图像传输构件和照明构件覆盖更大的视野。套管的旋转轨迹可进行设定，以保持图像在一个取向上。在各种实施例中，设置在套管组件中的加速计或编码器(例如机械式或光学式的)或者其它合适的反馈元件可与图像传输构件的视频输出中的控制电子器件通讯，以在它被显示给操作员之前旋转图像，以保持图像在同一取向上。反馈元件可具有固定参考点，以表明优选取向，诸如竖直或向上的取向。反馈元件的固定参考点对应于图像传输构件的特定参考点或取向。这可以是相同的取向，诸如向上的取向。套管的旋转可在没有用户干预的情况下自动完成，或者旋转可由操作员控制。在图像传输构件内，可具有公知且清楚理解的成像特征，包括电-光学成像稳定特征及其它特征。
套管组件的失效安全设计特征来自于用于可展开部204的铰链装置，铰链装置定位在远端116上游的位置。可展开部204可在套管组件的抽出时闭合，其通过在抽出过程中通过外部插入套管200施加在它上的力而实现。在这种构造中，无需操作调整装置106就可使展开部分204运动至闭合位置。
管状元件110的远端116的全部或部分可由光学透明材料形成为套针、或尖头、或者任何合适形状的前端形状。与占据腔202的全部或部分内部容积的可展开的或可移除的镜子组合，当可展开部204处于或邻近闭合位置处时，外科医生或操作员将能看到超出套管组件的前方视野。在替代实施例中，棱镜可用于替代镜子。
图5A和图5B示出套管组件100的一实施例，其中，套针的全部或部分由透光或光学透明材料制成。当可展开部204处于闭合位置500时，图像传输构件508能够经由光学路径512通过套管组件的远端502成像，光学路径512行进通过远端502上的窗口510、光管、或类似的透光介质。
在所述内腔内，镜子组件(其可为一个或多个适当反射的表面506)可以以合适的角度放置，以允许向前观察。反射表面506形成了穿过套管组件100的内腔202连接至近端114的连接件504(例如杆)，以允许在可展开部204打开后将镜子组件取出(如果需要的话)。
如图9A、图9B和图9C所示，套管组件900具有在可展开部204处于闭合位置时向前观察的能力。另外，套管组件900可包括可移除套针。远端形成两个部分的组合。一个是可展开部204(带有外表面902)，而另一个是可收回部904。可展开部204可由任何合适的材料制成，而可收回部904优选由透光或光学透明材料制成。透光或光学透明材料提供了窗口，窗口与位于内腔内(且与上述那些类似)的镜子组件组合允许在可展开部204处于关闭位置时成像传输构件向前观察。在展开后，可收回部904由外科医生或操作员经由所述内腔收回。
在一个实施例中，另外的照明源放置在外表面904中的面向远端的凹口内。这种照明源会使得从套针的透光部分返回到图像传输构件的反射最少。在替代实施例中，用于照明源的电源由放置在套管组件内的储能构件(例如处于手柄内的电池)来提供，以使得对套管组件的剩余部分的相互作用最少。外科医生可在插入套管组件时致动照明源。照明源可包括上述照明源中的任一个。储能构件可为电池或超级电容器。储能构件可附接于杆504或可连接于照明源。
已以一定程度的具体细节详细说明了本发明的各种实施例和特征。本领域技术人员能认识到其实用性。应强调的是，本发明的上述实施例仅说明了可能的实施实例，以阐明对本发明原理的清楚理解，而且在不脱离本发明原理的精神和范围的情况下可对在此说明的实施例进行各种变化、改型和修改。此外，这种改型和修改将被包含在如随附权利要求所述的本发明的范围内。本发明的范围由随附权利要求而非前述实施例的说明来限定。由此，希望由专利证书保护的是如下面权利要求书中限定并分化的本发明及所有等同物。
所主张的是：

Claims (25)

1.一种套管组件，包括：
管状元件，其形成内腔，所述管状元件具有近端和适于插入到体腔内的远端；
所述管状元件的可展开部，其接合在所述管状元件的远端附近，以在闭合位置和打开位置之间转换；以及
电子构件，其安装于所述管状元件的可展开部上，其中，当所述可展开部处于闭合位置时，所述电子构件至少部分地位于所述内腔内。
2.根据权利要求1所述的套管组件，其中，所述打开位置包括多个位置。
3.根据权利要求1所述的套管组件，其中，所述电子构件布置成当所述可展开部处于打开位置时远离所述内腔。
4.根据权利要求1所述的套管组件，其中，所述可展开部包括所述管状元件的壁部分。
5.根据权利要求1所述的套管组件，还包括可移除套针，所述可移除套针适于在所述可展开部处于闭合位置时安装到所述内腔中。
6.根据权利要求1所述的套管组件，其中，在所述可展开部处于闭合位置时，所述可展开部在所述管状元件的远端处形成尖头。
7.根据权利要求6所述的套管组件，其中，所述尖头包括光学透明材料，以在所述可展开部处于闭合位置时通过所述尖头将图像投射到所述电子构件上。
8.根据权利要求1所述的套管组件，其中，所述电子构件选自由以下对象构成的组：图像传输构件、照明构件、及它们的组合。
9.根据权利要求8所述的套管组件，其中，所述图像传输构件选自由以下对象构成的组：电荷耦合器件照相机、互补金属氧化物半导体成像器件、以及光纤线缆。
10.根据权利要求8所述的套管组件，其中，所述照明构件选自由光源和光纤线缆构成的组。
11.根据权利要求10所述的套管组件，其中，所述光源选自由以下对象构成的组：发光二极管、有机发光二极管、白炽灯、电致发光源、以及激光源。
12.根据权利要求1所述的套管组件，其中，所述管状元件的可展开部经由铰链装置在打开位置和闭合位置之间转换。
13.根据权利要求12所述的套管组件，其中，所述铰链装置设置于所述管状元件中。
14.根据权利要求13所述的套管组件，其中，所述铰链装置包括枢轴。
15.根据权利要求12所述的套管组件，其中，所述铰链装置设置于所述管状元件的圆周上。
16.根据权利要求15所述的套管组件，其中，所述铰链装置包括周向铰链。
17.根据权利要求12所述的套管组件，其中，所述铰链装置设置于所述管状元件的外部。
18.根据权利要求17所述的套管组件，其中，所述铰链装置包括至少一个四连杆机构。
19.根据权利要求1所述的套管组件，还包括致动机构，所述致动机构构造成使所述可展开部在闭合位置和打开位置之间转换。
20.根据权利要求19所述的套管组件，其中，所述致动机构包括：
设置于所述近端附近的旋钮；
至少一个连接件，其与所述旋钮联接；以及
铰链装置，其与所述至少一个连接件和所述可展开部连接，其中所述旋钮的旋转使所述可展开部在闭合位置和打开位置之间转换。
21.一种使用套管组件的方法，包括：
将具有内腔的管状元件插入到体腔中，其中，所述管状元件具有近端和远端；以及
将所述管状元件的可展开部围绕所述远端自闭合位置向打开位置致动，其中，当所述可展开部处于闭合位置时，安装于所述可展开部上的电子构件至少部分地位于所述内腔中，而当所述可展开部处于打开位置时，所述内腔基本没有障碍物。
22.根据权利要求21所述的使用套管组件的方法，还包括：采用所述电子构件来观察所述体腔的超出所述远端的部分。
23.根据权利要求21所述的使用套管组件的方法，还包括：当所述可展开部处于打开位置时，使外科工具和第二电子构件中的至少一个穿过所述内腔且超出所述远端。
24.根据权利要求21所述的使用套管组件的方法，还包括：首先将一插入套管引入到体腔中，从而经由所述插入套管插入所述管状元件。
25.根据权利要求24所述的使用套管组件的方法，还包括：经由所述插入套管将所述套管组件从体腔中抽出，使得通过所述插入套管施加到所述套管组件上的力将所述可展开部运动至闭合位置。
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BRPI1009863B8 (pt) 2021-06-22
WO2010111629A2 (en) 2010-09-30
CN102421384B (zh) 2014-11-12
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